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Original poster

gleason 3+4, Bone scan normal?

34 replies

Trumponerous · 27/12/2018 18:43

My poor DH has been told today he has prostate cancer, gleason score 3+4, PSA 4.8, aged late 50s. He had an MRI and a DRE. Can anyone tell me if the NHS routinely then do a bone scan or has something specific triggered the referral for one. The nurse giving results said it was given to everyone with a 7 but the NHS website seems to disagree.

This is so very hard, I know 3+4 is relatively good but not if the bones are affected.

OP posts:
Original poster
Trumponerous · 27/12/2018 20:32

Bumping because DH just asked me if I thought nurse was fibbing when she said everyone has bone scan. I asked her if the MRI had indicated spread but she claimed not to have that info.

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CMOTDibbler · 27/12/2018 20:46

I think the bone scan criteria just varies a bit. The MRI only looks at the prostate and just around it, so it wouldn't show if there was any bone spread - so def not triggered by that.
A PSA of only 4.8 is really good with a 3+4, and I wish your DH a smooth journey through whatever he and his clinical team choose for his treatment

redsummershoes · 27/12/2018 20:51

it's pretty standard. my dad has just been through it (not nhs though).
he has mri and ct scans which showed bone were clear and cancer was contained in/around prostrate.
had prostrate&adjoining lymph glands removed recently.
no further treatment apart from another mri/ct in a year's time, but the suregon was confident they were able to remove it all.

Original poster
Trumponerous · 27/12/2018 20:54

Thank you so much for replying CMOTDibbler. I keep telling myself that the results are relatively good and the left side of his prostate was a 3+3) Could it really have spread into the bones already?

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Original poster
Trumponerous · 27/12/2018 20:57

Thank you redsummer. Can I ask (anyone) how you go about finding a great surgeon? Can you choose on the NHS?

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CMOTDibbler · 27/12/2018 21:10

Did they tell him how many cores were 3+4?

The risk of having spread to the bone is very low, but obviously it is incredibly important to know this as early as possible

Original poster
Trumponerous · 27/12/2018 21:27

They did tell us but also said as we started writing stuff down that the info was on the form she was giving us, it wasn't. I just remember that half the prostate on one side (right side I got that wrong earlier) were 3s and on the other were minority 4s. They did target the side they felt a "small firm nodule at the left side midgland to apex" From DRE. Also described verbally after MRI as relatively small.

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Original poster
Trumponerous · 27/12/2018 21:28

There were 14 cores.

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mumsastudent · 27/12/2018 21:32

sometimes they do a bone scan to check if their bone density (certain treatments can thin bones) - is your fil on any medication -out of interest?

mumsastudent · 27/12/2018 21:35

prostatecanceruk.org/ this is a good resource & is informative than the NHS site.

Original poster
Trumponerous · 27/12/2018 21:35

No, it's my DH, not on any medication, no health issues till now.

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Original poster
Trumponerous · 27/12/2018 21:43

Thank you for the site. I am finding the US ones more detailed and helpful in general. I find it odd that the person givng results today actually couldn't or wouldn't answer detailed stuff like what kind of scan the bone one is, wasn't really on top of what the Gleason score actually meant re the cells and really only told us what was on the report in front of her. But we get another opportunity at next week's consultant meeting after tomorrow's bone scan and Monday's flow test.

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mumsastudent · 27/12/2018 21:45

about how old is dh? my dh was diagnosed over 10 years ago :) he had gleason 4-3 psa over 20 - he is fine - hand hold here from me - its a scary time - what area are you op? I would suggest choosing a surgeon from a big hospital - if you can

Original poster
Trumponerous · 27/12/2018 21:48

Thank you for helping. He is 58, we could go anywhere Oxfordshire Berkshire, London, Hampshire .

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ChristmasFlary · 27/12/2018 21:49

My dad was early 60s when he was diagnosed. No symptoms but I'd nagged him to have a PSA test as I've nursed many men with prostate cancer post surgery.

He had a bone scan. In my experience that's routine.

Original poster
Trumponerous · 27/12/2018 21:53

Yes mine had no symptoms. It was asked for by DH just because of the prostate awareness stuff about and because the Lions charity offered them this year.

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CMOTDibbler · 27/12/2018 21:59

The consultant is the one who can really go into everything with you, and talk about what it all means for treatment choices. Surgery, radiotherapy and brachytherapy are all options but exactly where the main tumour is, and how the MRI looks will affect what the recommendation is.

Original poster
Trumponerous · 27/12/2018 22:02

Thank you so much everyone.

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Diangled · 27/12/2018 22:13

My DH has stage 4 prostate cancer which was diagnosed earlier this year. He is in his mid 50’s. His has spread to his bones & lymph nodes however his PSA was over 200 at diagnosis. DH’s Gleason is 9.
I seem to believe that it is the gold standard to do a bone scan on all positive results of PC to rule out bone spread before any treatment takes place.

I know it’s easy to say try not to worry & impossible to do but the stats are on his side. Still, it’s a shitty horrible disease & the waiting is torturous. Sending very best wishes.

Original poster
Trumponerous · 27/12/2018 22:18

Thank you for taking the time for me Diangled. I am so sorry your DH and you are in this shitty position. I hope that you have many good times together still ahead of you.

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Paradyning · 27/12/2018 22:19

What sort of bone scan? A Dexa or nuclear medicine scan? I assumed the latter until a PP mentioned bone density tests.

Original poster
Trumponerous · 27/12/2018 22:24

It's nuclear I think because in the nuclear medicine block. Dye injection then 3hr wait before scan. It would have been nice to be told by the HCP when I asked though.

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Diangled · 27/12/2018 22:36

Thank you Smile. DH is doing so well & feels back to his old self. Back at the gym, working & fully partaking in life! It’s obviously always there & there are side effects but on the whole we are doing okay.

One of his oldest friends was bizarrely (I say bizarre as they have been close friends since late teens & both young for this disease. Kind of grates when the it’s an old mans disease line is trotted out!) diagnosed a year ago & his PSA was 7 at diagnosis. He had a bone scan (the nuclear medicine one you describe) which was clear. He had brachytherapy & is now simply monitored every 3 months. His life is also continuing as before. DH & I went shopping whilst his nuclear meds were doing there stuff. The scan itself takes a relatively long time too so don’t panic if you’re waiting a while.

Original poster
Trumponerous · 27/12/2018 22:41

I am glad he feels so well Diangled. That's useful to know we could leave, the paperwork says we can leave the department but I assumed we still had to stay in the hospital .

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dahliaaa · 28/12/2018 22:44

Hi OP - my DH was diagnosed with advanced PC 2 years ago. He had no symptoms but his psa was in the thousands (plus Gleason 9) and has spread all through his bones and lymph nodes.

Everything sounds very hopeful for you that everything is contained - and in that case the outcomes are very positive. I pray that at some stage in the not too distant future no more men will get to the stage of being diagnosed too late.

The initial waiting is difficult and you might find it helpful to call the nurses at the Prostate Cancer UK charity. The number is on their website and they are very helpful.